dexamethasone
Summary
Dexamethasone is a potent synthetic glucocorticoid with strong anti-inflammatory and immunosuppressive effects. It has minimal mineralocorticoid activity and a long half-life (36-54 hours), making it useful for conditions requiring sustained corticosteroid action.
Detail
Dexamethasone is a synthetic corticosteroid that binds to glucocorticoid receptors, leading to anti-inflammatory, immunosuppressive, and metabolic effects. It crosses the blood-brain barrier effectively and has 25-40 times the potency of cortisol. Clinical uses include cerebral edema (especially from brain tumors), severe asthma exacerbations, allergic reactions, autoimmune conditions, and as part of chemotherapy regimens. It's also used in the dexamethasone suppression test to diagnose Cushing's syndrome - normal patients suppress cortisol production while those with Cushing's do not. Side effects include hyperglycemia, immunosuppression, mood changes, osteoporosis, and adrenal suppression with prolonged use. During COVID-19, it became a standard treatment for severe cases requiring oxygen support due to its anti-inflammatory effects in reducing cytokine storm.
Sources
- First Aid for the USMLE Step 1
- Katzung's Basic & Clinical Pharmacology
- Harrison's Principles of Internal Medicine
- Goodman & Gilman's The Pharmacological Basis of Therapeutics
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